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Home My WebLink About2015-01378 (mechanical - fireplace) � � CITY OF ORONO * z p� 1 5 - 0 1 3 7 8 * 2750 KELLEY PARKWAY DATE ISSUED: 10/27/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 4565 BAYSIDE RD PIN : 06-117-23-21-0010 LEGAL DESC : BAYSIDE BERRY FARM : LOT 2 BLOCK 1 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL COI�ISTRUCTION TYPE : FIREPLACE-GAS VALUATION : $ 8,089.38 NOTE: HEAT-N-GLO GAS FIREPLACE APPLICANT MECHANICAL 101.12 STATE SURCHARGE MECH(VALUATION) 4.04 GLOWING HEARTH AND HOME MAIL-IN FEE 2.00 100 ELDORADO DRIVE JORDAN, MN 55352 TOTAL 107.16 (952)495-2927 Payment(s) CHECK 21947 107.16 OWNER DOUBECK,TIM&MARY 4565 BAYSIDE RD MAPLE PLAIN, MN 55359- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become n�ll and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time afrer work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. � � -� �� /� i�,1 i �S Applic nt Permitee Signature Date Issue y Signature Date . ` � � FO ITY L' � City of Orono � � � �-�� P O Box 66 �� f� ' ��"� Date Received: � �mit t Q�� O 2750 Kelley Parkway -- �- Crystal Bay,MN 5�323 C+��QF QR Approved By: Amount$: Phone(952)249-4600 Fax(952)249-4bi�N ..� a„ yF � �'��FSH�� CITY OF ORONO —MECHANICAL PERMIT _. (All Commercial permits must be approved by the Building Ofticial or Inspector and/or Fire Marshall) GENERAL INFORMATION I. You may apply for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. Z. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desiens—Complete calculations,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air conditioning installation including heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new construction or remodeling is involved,a separate building permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements. 6. Al(wori.must be inspected (rough-in and final). Ca11 (952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT (Check All That A l �Residential ❑ Commercial(Approval Required) � New ❑ Additional ❑ Repairs ❑ Replace Job Site/ Owner Information: Site Address: � � S � � �� j� �" � � ,/ .-�— Owner�-�� -�t,� � l. �� Mailing Address: ( `��._,/�l`�� `:�� ,�� ►ty: l��'_ ;�I C�( Ue 1✓i ��~'� � i ,� ! t%'�� z�p: � �� T� � . �� %il — — Home Phone: '� �� • � � ; �'` �� a Alternate Phone: Contractor Information: �� i' , n Contractori %��W �►�)f., I�� 1�/�� /T Contact Person: �i �1�� !��f� Address: �� `� State Bond #: �IC/ u�J� � � [� �. � ) , City: �� J/ �� ` Zip�i��J�piration Date: �L" �f � — �'_.;:� ��),��5 , , ! ,� "I � Phone: �� '�_� Alternate Phone: r�'. �, i-, � �f;;�'' i�.�i .E---r /' � i. [� Insurance—Current: �" � � � �� u�' �r�;�,��i,� 1 �,'� MECHAN�CAL SYSTEMS BEING INSTALLED �ED Note: All Geothermal Systems will now require a Site Plan & Review by our Building Official. �`'"'� IS THIc rEOTTIE??MAL? ❑ Yes ��?� HEATING SYSTEMS Quantity: Make: Model: Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H. Power FIREPLACES Gas Factory Fireplace Brand Name: ��L��' ' ` �� / � Wood Burning Fireplace , A ❑ Wood Stove Model No.: „ �`�� P � �V�- ��, ❑ Wood Stove with Flue/Masonry r P 1�n`^ /� t n I �V U V\G'� � ��V VENTILATION I Q �,.� � �L� . ❑ No. Kitchen Exhaust duct recirculating cfm ❑ No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations cfm FUEL STORAGE (Must be approved by Fire Marshall if proposing to abandon tank in place.) ❑ Installation ❑ Removal Fuel Oil: gallons ❑ Underground ❑ [nside ❑ Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What& Where: � � 2 i i , I'� . ."9��^�•�� ':,,.K; . ' � �� ' `_'--�-.._ .. PERMIT FEE CALCULATION(S) BASED OFF - 2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 1.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION S -JOBS OVER$SOQ.00 If above does not apply; follow guidelines below: !. Cf?'.�TRACT pRICE * :s 1.?54%o:�ccntract price with a(Mlin�:::um FeQ of$50,Q0) � 0 � � � �� X .ol�s $ I �J � , i �_� (contract price) (minimum�50.00) 2. STATE SURCHARGE �nQ� �� J� 1 �l U�� • �x.0005 $ ( � �� (contract price) 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � � � � i �•� ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations are furnished by the owner, tenant or any other party, the reasonable market value of such items must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may request the submission of a signed copy of the actual contract. MECHAN[CAL PERM[T APPLICATION AGREEMENT The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. / � �' Applicant's Signature � �� , �� Date: � � ' ��I �� '`� (. � �� :, 3 �;� i� , i:� �� D E TIME��'� CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED PERMIT NO. '2,�� 137�COMPLETED ADDRESS �S�O S 1 C}c-t/�S I' a� �c� OWNER TELEPHON No. ��a-�g�-9�� CONTRACTOR - � � � � DESCRIPTION �� '�'�JfZat'eS l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ P ❑ TREE REMOVAL _ ❑ RADON SLAB MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ I AL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: a V'�n�c � N G ��'.�s'�` 3 F'./� � � � 0 � ��v�h� �s /'i��s 7G` '�. �°- �r— � /�fa'L�e Go/J/Je✓ ��-a.i✓� St�,e� c� �� ) d��S`�iu/J 7�a.O �� S�S � . Q � W � 2 e.s��- �� W � j d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CWERING PERMANENT ❑ CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-46�� OwnerfContractor on site: Inspector. ��.�.� � White Copyllnspector's File Canary CopylSite Notice �� DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED `? /� - PERMIT NO.��:1�� T�! �� COMPLETED ADDRESS ��' �� OWNER TELEPHONE NO. �7 3'y� ir� CONTRACTOR 1 �1 CL �r � DESCRIPTION r �`�S� C?C� S l� ❑ FOOTING '�.� DEMO-FINAL ❑ SEPTIC FINAL � ` Q ❑ POURED WALL � PLUMBING RI ❑ EXCAV/�,RADING/FILLING y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ TIC INSTALL Z OWNERICONTRACTOFi TO MEET YOU:�YES_NO � �� v�i COMMENTS: � � i j O � � O � � r _ Q � � � z W � W � W RKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ECT VYORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hou in advance. 952 49- - OwnerlContractor on site: Inspector. White CopyRnspector's Ffle � Canary Cop ISite Notice � � � � DATE TIME � CITY OF ORONO CALLED IN INSPECTION NOTICE �i3��sCHEDULED _ ��/(p PERMIT NO._�� COMPLETED ADDRESS � � Ce c OWNER TELEPHONE . ,Z(''3 y� "�� CONTRACTOR r LLQ �/ � � c � DESCRIPTION '� � .� I�� /`' �� W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT J �E1NAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ S TIC INSTALL 2 OWNERfCONTRACTOFi TO MEET YOU:�YES_NO y COMMENTS: � � �s �- P Y / �� bk�� ° /� �C,�j�� c►a,vc�/e�'.� - � 0 � W � Q — — 2 �Q�.+�t.Y -Fi n��c.� W � W � � � ❑WORKSATISFACTORY:PROCEED p�ROJECTCOMPLEfE ` W ❑CORRECT WORK 8 PROCEED � ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED O STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 forthe next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: Inspector. � I ^^' 7� White Copyllnspector's File Canary CopylSite Notice